Berríos-Bárcenas E, Palacios E, Meave-González A, Laínez-Zelaya J, Alexanderson-Rosas E

Language: Spanish
References: 9
Page: 88-93
PDF size: 495.46 Kb.

ABSTRACT

Background: although coronary calcium has predictive value in the general population, in patients who are to undergo surgery for heart valve disease its true usefulness is unknown.
Objective: to determine the utility of coronary calcium assessment prior to valve surgery.
Material and methods: a dynamic cohort study which included patients over 35 years of age, of indistinct gender, with surgical valve disease. Subjects underwent measurements of calcium and coronary angiotomography as part of their evaluation prior to surgery. Subjects with obstructive coronary lesions (stenosis ≥ 50%) underwent invasive coronarography.
Results: from March 2010 through July 2013, 115 patients at Instituto Nacional de Cardiologia Ignacio Chavez in Mexico City were included, prospectively. The average age was 54.5 ± 11.4 years. Low prevalence of cardiovascular risk factors and predominance of aortic etiology was observed. Coronary calcium was below 100 Agatston units (AU), cardiovascular risk low, in 90% of the population, the same as for prevalence of obstructive coronary lesions (10%). The cutoff point of 120 AU showed ABC = 0.95 to predict significant coronary lesions. The need for invasive coronarography and revascularization was greater in the group with coronary calcium ≥ 120 AU (p ‹ 0.001).
Conclusion: in the evaluation prior to heart valve surgery a coronary calcium score ≥ 120 AU is associated with a higher likelihood of requiring invasive coronarography or revascularization; it is, therefore, a useful parameter to decide to continue with angiotomography or refer the patient directly to coronarography. This could result in lower costs and exposure to ionizing radiation and contrast medium.

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